Latest Drugwonks' Blog
The first post of our new CMPI fellow ... Marc Siegel MD
The spread of Elizabeth Edwards cancer may provoke the public to many reactions: sympathy, empathy, worry. Surely, we all hope that this unfortunate event won't be grounds for either political gain or loss. Surely, we all hope that any public discussion of cancer spread will be grounds for more cancer awareness and prevention and treatment advances.
It was just last week that I wrote an oped in the WSJ about the importance of diagnosing lung cancer before it escapes the lung. I pointed out the need for effective use of technologically advanced CT scanning for this to happen.
I mentioned breast cancer as an example of another cancer where early detection was important for reduced morbidity and lifestyle advantage, if not survival.
Of course breast cancer is generally not as aggressive and is somewhat more responsive to chemotherapy.
But what Mrs. Edwards case points out is just how treacherous the disease is, and just how expensive and emotionally costly treatments for advanced cancer are.
Metastases to the bone, as Mrs. Edwards has sustained, tend to be somewhat amenable to chemotherapy, so that if not a cure, at least this patient can hope for a long term remission and an effective and happy life.
I do not know the details of Edwards' case, or how it was diagnosed. As we all hope for the best outcome for this public figure, I can't help but hope that many other women have their cancer caught as early as possible, whether by mammogram, or breast exam, or by whatever MRI technology becomes more accessible and useful for breast screening. While we hope for the longest life possible for Mrs. Edwards and those like her who suffer from metastatic cancer, we also hope that expensive treatments for metastatic disease can be avoided as frequently as possible as the result of advances in techniques of early detection.
Marc Siegel MD
Dr. Siegel is a prolific writer, an Associate Professor of Medicine and a Fellow in the Master Scholars Society at New York University School of Medicine, a columnist for the Los Angeles Times, a frequent contributor to the Washington Post and Family Circle. He is a member of the board of contributors at USA Today. He appears frequently on CNN, the Fox News Channel, and the NBC Today Show.
Dr. Siegel's "False Alarm: The Truth About the Epidemic of Fear" has been named one of the "Top Science Books of the Year"
The spread of Elizabeth Edwards cancer may provoke the public to many reactions: sympathy, empathy, worry. Surely, we all hope that this unfortunate event won't be grounds for either political gain or loss. Surely, we all hope that any public discussion of cancer spread will be grounds for more cancer awareness and prevention and treatment advances.
It was just last week that I wrote an oped in the WSJ about the importance of diagnosing lung cancer before it escapes the lung. I pointed out the need for effective use of technologically advanced CT scanning for this to happen.
I mentioned breast cancer as an example of another cancer where early detection was important for reduced morbidity and lifestyle advantage, if not survival.
Of course breast cancer is generally not as aggressive and is somewhat more responsive to chemotherapy.
But what Mrs. Edwards case points out is just how treacherous the disease is, and just how expensive and emotionally costly treatments for advanced cancer are.
Metastases to the bone, as Mrs. Edwards has sustained, tend to be somewhat amenable to chemotherapy, so that if not a cure, at least this patient can hope for a long term remission and an effective and happy life.
I do not know the details of Edwards' case, or how it was diagnosed. As we all hope for the best outcome for this public figure, I can't help but hope that many other women have their cancer caught as early as possible, whether by mammogram, or breast exam, or by whatever MRI technology becomes more accessible and useful for breast screening. While we hope for the longest life possible for Mrs. Edwards and those like her who suffer from metastatic cancer, we also hope that expensive treatments for metastatic disease can be avoided as frequently as possible as the result of advances in techniques of early detection.
Marc Siegel MD
Dr. Siegel is a prolific writer, an Associate Professor of Medicine and a Fellow in the Master Scholars Society at New York University School of Medicine, a columnist for the Los Angeles Times, a frequent contributor to the Washington Post and Family Circle. He is a member of the board of contributors at USA Today. He appears frequently on CNN, the Fox News Channel, and the NBC Today Show.
Dr. Siegel's "False Alarm: The Truth About the Epidemic of Fear" has been named one of the "Top Science Books of the Year"
A taste of the stale debate about Medicare that took -- and will take place -- in Congress. I am so glad I have HBO...
Senator Jon Cornyn sponsored an amendment that would make high income Medicare beneficiaries to pay higher premiums for prescription drugs. It went down in flames.
Not before it got doused by with rhetorical kerosene by Democrat Sen. Sherrod Brown who claimed that Republicans "come to the floor of this chamber ... over and over, from every different direction they attack one of the single greatest programs that this government has ever done."
As opposed to shoving every senior into a VA or Canadian style drug program Senator?
How about enlisting seniors, doctors and others to save Medicare money by not using services and staying healthy? We have taken some steps in that direction but I fear that we are not going to get much traction with Democrats in control...
Senator Jon Cornyn sponsored an amendment that would make high income Medicare beneficiaries to pay higher premiums for prescription drugs. It went down in flames.
Not before it got doused by with rhetorical kerosene by Democrat Sen. Sherrod Brown who claimed that Republicans "come to the floor of this chamber ... over and over, from every different direction they attack one of the single greatest programs that this government has ever done."
As opposed to shoving every senior into a VA or Canadian style drug program Senator?
How about enlisting seniors, doctors and others to save Medicare money by not using services and staying healthy? We have taken some steps in that direction but I fear that we are not going to get much traction with Democrats in control...
Why is it that only some groups need to be transparent? In many of today's news reports on the FDA's new draft guidance on advisory committee conflict of interest some groups are deemed "consumer advocates" -- but no mention is made of their funding sources, while other organizations are quoted, but tagged "industry funded."
Why is this?
For example:
http://www.baltimoresun.com/news/nationworld/bal-te.fda22mar22,0,763576.story?coll=bal-home-headlines
A good story by a solid reporter -- but shouldn't there be transparency for all concerned?
Isn't that the point?
Why is this?
For example:
http://www.baltimoresun.com/news/nationworld/bal-te.fda22mar22,0,763576.story?coll=bal-home-headlines
A good story by a solid reporter -- but shouldn't there be transparency for all concerned?
Isn't that the point?
How about a $50K cap for anyone who has taken money a legal expert in a plaintiffs suit or as a consultant thereof or has received a cut from a personal injury or product liability suit. How about anyone who has received large grants from private foundations or government in excess of that amount?
My prediction: just as you saw an exodus of the best and brightest from the NIH as a result of a restrictive and hyper-reactive cap on consulting to crack down on the appearance of the appearance of a conflict, the same will happen with Advi Comms at the FDA. You will get mediocre, unmotivated or ideologically driven researchers populating committees and using the proceedings to promote their particular positions.
http://online.wsj.com/article/SB110980263395968693.html
My prediction: just as you saw an exodus of the best and brightest from the NIH as a result of a restrictive and hyper-reactive cap on consulting to crack down on the appearance of the appearance of a conflict, the same will happen with Advi Comms at the FDA. You will get mediocre, unmotivated or ideologically driven researchers populating committees and using the proceedings to promote their particular positions.
http://online.wsj.com/article/SB110980263395968693.html
Another smear job on another servant of the public health, Allen Collins, as head of the National Kidney Foundation as part of a INDEPENDENT group of experts developed guidelines to develop EPO levels to a point where people on dialysis lived longer and better lives.
Somehow that never got into the smear job Gardiner Harris did on him...
http://www.nytimes.com/2007/03/21/us/21drug.html?ei=5087%0A&em=&en=1b7a123ccba022cd&ex=1174622400&pagewanted=print
In case anyone is interested in a real contribution to the public health, here a link to the work undertaken by Dr. Collins
http://www.kidney.org/PROFESSIONALS/kdoqi/nkfAdvisory.cfm
Somehow that never got into the smear job Gardiner Harris did on him...
http://www.nytimes.com/2007/03/21/us/21drug.html?ei=5087%0A&em=&en=1b7a123ccba022cd&ex=1174622400&pagewanted=print
In case anyone is interested in a real contribution to the public health, here a link to the work undertaken by Dr. Collins
http://www.kidney.org/PROFESSIONALS/kdoqi/nkfAdvisory.cfm
Here is the link to the relevant documents:
http://www.fda.gov/bbs/topics/NEWS/2007/NEW01591.html
If you are conflicted (either existentially or actually), I grant you a waiver to view these materials.
http://www.fda.gov/bbs/topics/NEWS/2007/NEW01591.html
If you are conflicted (either existentially or actually), I grant you a waiver to view these materials.
I am currently listening to an FDA stakeholder call on a new draft guidance for FDA advisory committee conflict of interest.
Rather than "in" or "out," the agency is suggesting three options:
(1) If an adcomm member has "some" conflicts, they can sit on the committee and participate in the meeting -- but cannot vote.
The FDA did not define what "some" means.
(2) If an adcomm member receives more than $50,000 compensation from a firm in front of an adcomm, they may not sit on the panal, participate in the debate, or vote.
It isn't clear (at least to me) in what period of time this money can be accrued (i.e., $50,000 in a calendar year, or in 12 months prior to the meeting, etc.).
(3) If a panel member has the "appearance" of a conflict they may be recused.
No definition of what "appearance" means. Perhaps this will be clarified in the actual draft guidance.
More as more develops.
Rather than "in" or "out," the agency is suggesting three options:
(1) If an adcomm member has "some" conflicts, they can sit on the committee and participate in the meeting -- but cannot vote.
The FDA did not define what "some" means.
(2) If an adcomm member receives more than $50,000 compensation from a firm in front of an adcomm, they may not sit on the panal, participate in the debate, or vote.
It isn't clear (at least to me) in what period of time this money can be accrued (i.e., $50,000 in a calendar year, or in 12 months prior to the meeting, etc.).
(3) If a panel member has the "appearance" of a conflict they may be recused.
No definition of what "appearance" means. Perhaps this will be clarified in the actual draft guidance.
More as more develops.
Want the facts and nothing but the facts on Medicare Advantage?
Of course you do, you're a drugwonk!
Have a look at this document:
Download file
CMPI is glad to have assisted in putting this fact sheet together.
Of course you do, you're a drugwonk!
Have a look at this document:
Download file
CMPI is glad to have assisted in putting this fact sheet together.
Here's a link to the complete BioCentury feature, "Deconstructing FDAMA."
Download file
Many thanks to Bard Steve and BioCentury for the permission to share.
Download file
Many thanks to Bard Steve and BioCentury for the permission to share.
Steve Usdin certainly has a way with words. Consider these pearls from the recent edition of BioCentury:
"Part of the lesson from FDAMA is that the road to regulatory perdition is paved with the best legislative intentions.
The fact is the Congress did not accompany its 1997 mandate for new treatments with any risks for FDA's failure to perform, and hasn't followed through with the resources to bring regulatory science into the 21st century.
Lawmakers also lost interest in the outcome, and now have turned their attention to raising political capital by easy grandstanding about safety.
The truth is that neither Vioxx nor anti-depressants, nor Ketek rise to the level of thalidomide. If it were so, then there would be a groundswell of calls to roll back FDAMA's mandate to being new treatments to patients who need them.
But even if there is no return to the pre-1997 era de jure, a de facto rollback is a real possibility unless Congress, regulators, patients and industry again are willing to do the hard work required to build the sophisticated systems to improve the risk-benefit calculus. This revived collaboration is necessary to make palatable the regulatory risk that everyone must accept if the new science is to make its way to the bedside."
We hereby dub Sir Steve the "Bard of BioCentury."
"Part of the lesson from FDAMA is that the road to regulatory perdition is paved with the best legislative intentions.
The fact is the Congress did not accompany its 1997 mandate for new treatments with any risks for FDA's failure to perform, and hasn't followed through with the resources to bring regulatory science into the 21st century.
Lawmakers also lost interest in the outcome, and now have turned their attention to raising political capital by easy grandstanding about safety.
The truth is that neither Vioxx nor anti-depressants, nor Ketek rise to the level of thalidomide. If it were so, then there would be a groundswell of calls to roll back FDAMA's mandate to being new treatments to patients who need them.
But even if there is no return to the pre-1997 era de jure, a de facto rollback is a real possibility unless Congress, regulators, patients and industry again are willing to do the hard work required to build the sophisticated systems to improve the risk-benefit calculus. This revived collaboration is necessary to make palatable the regulatory risk that everyone must accept if the new science is to make its way to the bedside."
We hereby dub Sir Steve the "Bard of BioCentury."
Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.
